Eczema / Atopic Dermatisis

Eczema is a word that describes a variety of very common skin conditions. “Atopic” eczema is a rash seen in people who often have other environmental allergies or asthma. About 10% of the population is affected in the U.S. The condition is most common in infants and young adults and typically improves before the age of 25. Many patients continue to have eczema througout life.

Seborrheic Dermatitis

Seborrheic dermatitis (SD) is common skin disorder characterized by redness and scaling most commonly on the scalp, side of the nose, eyebrows and skin behind the ears. A yeast-like organizm may be involved in causing SD. Dandruff refers to scaling on the scalp without redness. Seborrhea refers to excessive oiliness of the skin without redness or scaling.

SD is most commonly seen in infants (“cradle cap”), middle age, and in the elderly. It is more common in people with oily skin or hair.

SD is easily controlled with medicated shampoos, mild corticosteroid creams, or antifungal preparations. More severe cases are treated with stronger prescription medications

Tinea Versicolor

Tinea versicolor (TV) or “summer rash” is a very common condition caused by the overgrowth of a skin surface yeast. The rash has variably sized scaly patches on the neck, upper chest and back. The fungus spreads slowly and can keep the skin from tanning normally.

TV is most common in teenagers and young adults. Although the fungus that causes TV is present on everyone’s skin, it seems to like some people more than others. It is worse during the hot, humid months of summer and can recur after treatment.

TV is fairly easy to treat with topical or oral medications. After treatment, symptoms of itching, redness and scaling resolve quickly. The change in pigmentation can take months to return to normal.


Rosacea is a common condition affecting the central face area of adults. It is characterized by redness or flushing, pimples, enlarged visible blood vessels, and occasionally an elnlarged, bumpy nose. The first sign of rosacea is usually rosy cheecks.

Rosacea is most common in fair skinned people of Anglican or Scottish decent and tends to run in families.

Many common things can aggravate rosacea. The list commonly includes exercise, stress, sun exposure, changes in temperature, hot showers or baths, spicy food, caffeine, and alcohol. Many foods can also make rosacea worse.

Although rosacea is a chronic condition, it is controllable with medication, including topical medication and oral antibiotics. Reducing exposure to rosacea triggers also helps. For more information, follow our link to the National Rosacea Society.


Warts are common, benign but contagious skin growths caused by a viral infection in the upper layers of the skin. The virus that causes warts is the human papillomavirus. There are many types of warts, including common warts, genital warts, foot warts (planter) and flat warts.

Common warts usually grow around the fingernails and on the hands. Elbows and knees are another common area. There are hundreds of different methods of treating warts proving that there is no one fail-safe method. Warts will sometimes rapidly disappear even without specific treatment. Common treatments include salicylic acid, freezing, cantharidin, and topical immunotherapy. The over-the-counter freezing method often fails

Genital warts are also quite common in both men and women and can be very difficult to treat. Common methods include freezing, podophyllin and imiquimod (Aldara).

Plantar (foot) warts can be very painful and can make it difficult to walk or wear certain shoes. They are notoriously tough to treat but also may spontaneously resolve. Salicylic acid and other chemical treatments are most commonly used. Surgical removal is a last resort due to the potential for scarring and recurrence.


Psoriasis is a chronic scaling skin disorder that produces red, inflamed, thickended areas with silvery scales. Psoriasis got its name from the Greek word for “itch”. The cause is unknown, but the condition tends to run in families. Any age can be affected.

Psoriasis comes in many forms, depending on the location on the body and the severity of the disease. Most commonly, it begins as small red bumps that expand into larger, thicker scaly patches. It is most often seen on the elbows, knees and scalp but can be gereralized and severe. About 30% of psoriasis patients have arthritis with or without the skin rash.

Common treatments for psoriasis include topical steroid preperations, tar-based preperations, ultraviolet light treatment, systemic agents and biological agents. The newer biological agents are showing some promise in the treatment of psoriasis, but are not curative and are quite expensive.


Urticaria is the medical word for hives, or “whelps”. The lesions of urticaria are caused by the release of histamine from blood cells and have many different triggers.

Allergic reactions to internal or external exposures, medications and foods may all trigger urticaria. In many cases, the exact cause cannot be determined despite extensive testing.

The lesions of urticaria are pale, pink well-defined swellings in the skin on any area of the body. They are typically very itchy and usually last less than 24 hours in any one area before redeveloping else where. In a small percentage of patients, urticaria lasts more than 6 weeks and is called “chronic uticaria”. The cause of this kind of uticaria is very difficult to identify.

The best treatment for hives is to eliminate the cause. Unfortunatly, the cause can be elusive in many cases. Antihistamines, especially in various combinations, can be effective in controlling the signs and symptoms of uticaria.

Atypical (Dysplastic) Moles

Atypical or dysplastic moles (nevi) are benign growths that may have some of the clinical features of melanoma. These features include asymmetry, irregular borders, variable coloration and large size. The risk of developing melanomaa is higher in patients who have multiple dysplastic nevi.

Familial Atypical Mole Syndrome (FAMS) is characterized by the following criteria:

  1. A first or second-degree relative with malignant melanoma.
  2. A large number of moles(> 50), some of which are atypical.
  3. Moles that have cerrtain microscopic features.

Due to the increased risk of developing melanoma, patients with FAMS should be evaluated by a dermatologist every 3 to 6 months. Baseline photography and mole mapping (now available at Greenville Hospital System) may help patients and dermatologists recongnize subtle changes in moles.

Treatment usually consists of conservative surgical removal. Atypical moles do not need to be treated as aggressively as melanoma. Avoidance of ultraviolet light, protective clothing and sunscreen can help prevent the development of melanoma.

Actinic Keratoses

Actinic keratoses(“AK’s”) are rough, sand-papery red skin lesions in sun-exposed skin. They are seen more often in fair-skinned individuals who have a significant history of chronic sun exposure. Fisherman, golfers, farmers, construction workers and others who spend a great deal of time outdoors are at increased risk.

AK’s are important to diagnose and treat because if left untreated they can progress to squamous cell skin cancer. Squamous cell skin cancer is the second most common skin cancer and potentially spread to other areas of the body.

Most AK’s are surgically treated with cryosurgery (freezing). this form of treatment is very effective for individual lesions. More broadly affected areas can be treated at home with prescription medication. Lasers and electrosurgery have also been used.


Acne is extremly common and affects most teenagers to some degree. Acne is caused by hormone changes that cause excess production of oil. Pores become blocked and bacteria begin to multiply and cause inflammation (redness). The tendency to develop acne is inherited and is not significantly affected by diet.

Typical acne consist of blackheads, pimples, and cysts or nodules that are deeper in the skin. Since some acne lesions can cause permanent scarring, early treatment is important. For less severe acne, over the counter medications containing benzoyl peroxide may be helpful. Moderate or severe cases may require more aggressive therapy with prescription medications. The only “cure” for acne is growing out of it. For most patients, acne is a temporary condition that leaves behind no permanent damage.